ED whiteboard helps HHC streamline patient management

The New York City-based Health and Hospitals Corporation sees 1 million emergency department visits per year, and has significant challenges to serve its underinsured and uninsured population.

To that end, technology in the form of a digital whiteboard system is helping the ED departments keep track of everyone coming in, according to Louis Capponi, chief medical informatics officer for HHC. In an exclusive interview with FierceHealthIT, Capponi said that more than 90 percent of HHC's admissions come through the ED, meaning it's vital to be as efficient as possible.

"Hospital leadership has been very supportive of the fact that we're going to have to leverage technology to meet the needs of patients and support the workforce," Capponi said.

Several years ago, HHC looked at its 11 emergency rooms and realized they had no way to monitor them or look at what was happening day-to-day. First, they started standardizing the intake process.

The hospital developed a whiteboard and dashboard that shows information for patients on flat screen TVs in the ED--every step of the process is documented on the screens. This is helping avoid duplication of information, avoiding bottlenecks in the ED and spreading out the workforce and clinicians where they're needed. The emergency room is not an ideal place to be for a patient with clinical needs, Capponi said, so patients are triaged as soon as they walk in and their status is updated onto the whiteboards, helping them be sent to the right place.

Every step in the care process produces an interface message that populates itself on the screen, Capponi said.

"What we have heard universally from the management staff is this is a tool they can't live without," Capponi said. "They can't go back to guessing what's going on."

A telehealth pilot for adolescent psychiatry consultations also recently proved to be a hit at HHC, Capponi said.

"It was very much successful and satisfactory, to the patients, the patients' families and clinicians," Capponi said. "It resulted in the avoidance of several hospitalizations, multiplied across our whole system. Only one in 10 patients wound up getting hospitalized [after the telehealth consultation]."

Added Capponi: "The impact was very profound in terms of the number of patients that were able to discharged safely."

Editor's Note: This article is the second in a series about the use of technology at the New York City Health and Hospitals Corporation. Read part one here.